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Reactive synovitis after silicone arthroplasty.

C A Peimer, J Medige, B S Eckert

    The Journal of Hand Surgery
    |September 1, 1986
    PubMed
    Summary
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    Silicone implants can cause erosive osteolysis and inflammatory synovitis, leading to joint destruction. Surgical removal of implants and affected tissue is necessary to halt this process and preserve joint function.

    Area of Science:

    • Orthopedic Surgery
    • Biomaterials Science
    • Pathology

    Background:

    • Silicone rubber implants were used for various joint arthroplasties.
    • Some patients experienced delayed complications including swelling and discomfort.

    Purpose of the Study:

    • To investigate the cause of implant failure and subsequent joint destruction.
    • To identify the pathological changes associated with silicone arthroplasty.

    Main Methods:

    • Studied 18 patients with silicone arthroplasties presenting with complications.
    • Analyzed implant surfaces using scanning electron microscopy and x-ray spectrometry.
    • Evaluated histopathology of synovitis and multinucleated giant cells.

    Main Results:

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    • Erosive osteolysis and progressive joint destruction were observed radiographically.
    • Silicone microparticles resulting from implant degeneration were identified.
    • Inflammatory synovitis severity correlated with time since arthroplasty.

    Conclusions:

    • Silicone particulate synovitis causes joint destruction.
    • Implant removal, synovectomy, and curettage arrested the destructive process.
    • Long-term follow-up of patients with silicone arthroplasties is recommended.